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Organizational Cullture

In ALF patients(P), does staff education and proper staffing (I), compared to lack of education and poor staffing (c)  decrease elderly abuse in ALF?(o), over duration of stay (T).

Describe the background of the problem. Identify the stakeholders/change agents and list the interested parties. Provide the PICOT question. State the purpose and project objectives in specific, realistic, and measurable terms. Develop an initial reference list.

The problem description and objectives are presented in detail and align. The stakeholders/change agents – who or what organizations are concerned, may benefit from, or are affected by this proposal – are described. The problem is in the PICOT format and developed appropriately. Objectives are measurable. The problem selection is justified using literature and supportive examples, not just based on the most current evidence. Expected changes before and after the evidence-based practice are integrated. An initial reference list is developed. Clarity and specificity of comprehension are demonstrated, and all relevant information is synthesized. Coverage extends beyond what is needed to support subject matter. Writer is clearly in command of standard, written, academic English

Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:

1.Describe the background of the problem. Tell the story of the issue and why it deserves attention.

2.Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.

3.Use the feedback from the Topic 2 main forum post and refine your PICOT question. Make sure that the question fits with your graduate degree specialization.

4.State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.

5.5) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.

6.Develop an initial reference list to assure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use “NUR-699 Search Method Example” to assist you.

7.7) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.

8.Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.

Steps to an Efficient Search to Answer a Clinical Question Box 3.3

Begin with PICOT question—generates keywords.

? Establish inclusion/exclusion criteria before searching so that the studies that answer the question are easily identifiable. Apply these criteria after search strategy is complete

? Use subject headings, when available.

? Expand the search using the explode option, if not automatic.

? Use available mechanisms to focus the search so that the topic of interest is the main point of the article.

?Combine the searches generated from the PICOT keywords that mapped onto subject headings, if the database does not automatically do this for you.

? Limit the fina cohort of studies with meaningful limits, such as language, human, type of study, age, and gender.

? Organize studies in a meaningful way using reference management software. 

Search Method Example

Search Method

A comprehensive electronic search was completed using the following databases:

Cochrane Central Register of Controlled Trials 

Cochrane Database of Systematic Reviews

National Guideline Clearinghouse 

CINAHL 

Ovid 

Medline 

The search included English-only published articles between 1990 and 2005. 

Key words used in the search were: 

Pediatric asthma education

Self-management 

Self-monitoring

Grade school children

Systematic reviews 

Randomized controlled trials 

Search results revealed 75 publications. The abstracts were screened and 10 studies were relevant to pediatric asthma education involving self-management, self-monitoring behaviors, self-efficacy, and educational programs with various interventions. These studies included three systematic reviews, five randomized control trials (RCT), one cohort descriptive study, and one qualitative study. Refer to Appendix A for a complete reference list.

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